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The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series

BACKGROUND: Benign biliary strictures can have a significant negative impact on patient quality of life. There are several modalities which can be utilized with the goal of stricture resolution. These techniques include balloon dilatation, placement of multiple plastic stents and more recently, the...

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Autores principales: Mallette, Katlin, Hawel, Jeffrey, Elnahas, Ahmad, Alkhamesi, Nawar A., Schlachta, Christopher M., Tang, Ephraim S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589998/
https://www.ncbi.nlm.nih.gov/pubmed/37865737
http://dx.doi.org/10.1186/s12876-023-02998-8
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author Mallette, Katlin
Hawel, Jeffrey
Elnahas, Ahmad
Alkhamesi, Nawar A.
Schlachta, Christopher M.
Tang, Ephraim S.
author_facet Mallette, Katlin
Hawel, Jeffrey
Elnahas, Ahmad
Alkhamesi, Nawar A.
Schlachta, Christopher M.
Tang, Ephraim S.
author_sort Mallette, Katlin
collection PubMed
description BACKGROUND: Benign biliary strictures can have a significant negative impact on patient quality of life. There are several modalities which can be utilized with the goal of stricture resolution. These techniques include balloon dilatation, placement of multiple plastic stents and more recently, the use of metal stents. The aim of this study was to evaluate the local success of self-expanding metal stents in successfully resolving benign biliary strictures. METHODS: This was a single institution, retrospective case series. Patients included in our study were patients who underwent endoscopic retrograde cholangiopancreatography with placement of self expanding metal stents for benign biliary strictures at our institution between 2016–2022. Patients were excluded for the following: malignant stricture, and inability to successfully place metal stent. Data was evaluated using two-sided t-test with 95% confidence interval. RESULTS: A total of 31 patients underwent placement of 43 self-expanding metal stents and met inclusion criteria. Mean age of patients was 59 ± 10 years, and were largely male (74.2% vs. 25.8%). Most strictures were anastomotic stricture post liver transplant (87.1%), while the remainder were secondary to chronic pancreatitis (12.9%). Complications of stent placement included cholangitis (18.6%), pancreatitis (2.3%), stent migration (20.9%), and inability to retrieve stent (4.7%). There was successful stricture resolution in 73.5% of patients with anastomotic stricture and 33.3% of patients with stricture secondary to pancreatitis. Resolution was more likely if stent duration was > / = 180 days (73.3% vs. 44.4%, p < 0.05). There was no demonstrated added benefit when stent duration was > / = 365 days (75% vs. 60.9%, p = 0.64). CONCLUSIONS: This study demonstrates that self expanding metal stents are a safe and effective treatment for benign biliary strictures, with outcomes comparable to plastic stents with fewer interventions. This study indicates that the optimal duration to allow for stricture resolution is 180–365 days.
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spelling pubmed-105899982023-10-22 The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series Mallette, Katlin Hawel, Jeffrey Elnahas, Ahmad Alkhamesi, Nawar A. Schlachta, Christopher M. Tang, Ephraim S. BMC Gastroenterol Research BACKGROUND: Benign biliary strictures can have a significant negative impact on patient quality of life. There are several modalities which can be utilized with the goal of stricture resolution. These techniques include balloon dilatation, placement of multiple plastic stents and more recently, the use of metal stents. The aim of this study was to evaluate the local success of self-expanding metal stents in successfully resolving benign biliary strictures. METHODS: This was a single institution, retrospective case series. Patients included in our study were patients who underwent endoscopic retrograde cholangiopancreatography with placement of self expanding metal stents for benign biliary strictures at our institution between 2016–2022. Patients were excluded for the following: malignant stricture, and inability to successfully place metal stent. Data was evaluated using two-sided t-test with 95% confidence interval. RESULTS: A total of 31 patients underwent placement of 43 self-expanding metal stents and met inclusion criteria. Mean age of patients was 59 ± 10 years, and were largely male (74.2% vs. 25.8%). Most strictures were anastomotic stricture post liver transplant (87.1%), while the remainder were secondary to chronic pancreatitis (12.9%). Complications of stent placement included cholangitis (18.6%), pancreatitis (2.3%), stent migration (20.9%), and inability to retrieve stent (4.7%). There was successful stricture resolution in 73.5% of patients with anastomotic stricture and 33.3% of patients with stricture secondary to pancreatitis. Resolution was more likely if stent duration was > / = 180 days (73.3% vs. 44.4%, p < 0.05). There was no demonstrated added benefit when stent duration was > / = 365 days (75% vs. 60.9%, p = 0.64). CONCLUSIONS: This study demonstrates that self expanding metal stents are a safe and effective treatment for benign biliary strictures, with outcomes comparable to plastic stents with fewer interventions. This study indicates that the optimal duration to allow for stricture resolution is 180–365 days. BioMed Central 2023-10-21 /pmc/articles/PMC10589998/ /pubmed/37865737 http://dx.doi.org/10.1186/s12876-023-02998-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Mallette, Katlin
Hawel, Jeffrey
Elnahas, Ahmad
Alkhamesi, Nawar A.
Schlachta, Christopher M.
Tang, Ephraim S.
The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
title The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
title_full The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
title_fullStr The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
title_full_unstemmed The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
title_short The utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
title_sort utility of self-expanding metal stents in benign biliary strictures- a retrospective case series
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589998/
https://www.ncbi.nlm.nih.gov/pubmed/37865737
http://dx.doi.org/10.1186/s12876-023-02998-8
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